Basketball Coaches Without Boundaries 

A New Generation of Coaches for the next Generation of Student Athletes

Complete, Print, Sign and Mail to BCWB, P. O. Box 3528, Frederick, Md. 21705

Return to Summer Rates Details

$80 Per Player

First &  Last Name                       Boys  League    

Home Address                              Girls  League 

City, State and Zip  

Home Phone               Cell Phone

Email Address        

School                        

Grade          3rd       4th       5th       6th       7th        8th       
             

T-Shirt Size  Adult  Small  Med  Large   X-Large  XX-Large       Youth    Small     Med   Large     X-Large

(Please select one)

 

Have you ever played in any BCWB Basketball Program     Summer League     Fall League    TJMS Mid-Maryland Team   AAU

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Would  you like to volunteer?     Name:    Email: 

                                                                                        Head Coach            Elementary/Middle School               

                                                                                        Assistant Coach    Elementary/Middle School      

                                             Concessions                                             Scorekeeper                                   Timekeeper

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Special Request (coach, team, on same team with another player, etc.)

No Refunds after:      June 11th (Summer Basketball League)

 

Medical Release & Registration Agreement  

The undersigned, parent/legal guardian of the player requesting league admittance, does hereby affirm that the applicant is in good health and suffers from no illness, disability, or condition that requires the taking of medication on regular basis unless that condition is disclosed and approved. Furthermore, the undersigned has no knowledge of any reason the applicant cannot participate in vigorous physical activity. The undersigned hereby expressly agrees to be responsible for any medical bills incurred in the treatment of any illness or accident. In the event of any such accident or injury, I hereby consent to allowing any of the league supervisors to procure any medical treatment deemed advisable on behalf of my child or ward without prior consent. I understand that, as a condition of admittance as a league participant, the undersigned, on behalf of all parents and guardians, and behalf of the applicant, hereby release Basketball Coaches Without Boundaries and all other employees or agents of the league from any and all liability in regards to injury or illness, either mental or physical suffered by the league participant during or related to the league by the person or entity against which the claim is made.                         

 

Parent Signature _________________________________________________________   Date ______________________